How is the epidemiology of heterosexually-acquired\ud HIV infection evolving, particularly among black Africans, in England, Wales and Northern Ireland?

Doctoral thesis English OPEN
Rice, Brian
  • Subject: R | RA0421
    mesheuropmc: virus diseases

In the United Kingdom (UK), an estimated 107,800 people were living with HIV in 2013, of whom 55% were heterosexual men and women. Black African men and women accounted for the majority of heterosexuals living with HIV in the UK in 2013. In this PhD by prospective publication my research question is “How is the epidemiology of heterosexually-acquired HIV infection evolving, particularly among black Africans, in England, Wales and Northern Ireland?”. I conducted a quantitative analysis of national surveillance datasets and undertook literature searches. Most of my analysis was based on data from the three national HIV surveillance systems which constitute the HIV and AIDS Reporting System (New HIV Diagnoses database; Survey of Prevalent HIV Infections Diagnosed; CD4 Surveillance Scheme). I published the results of my analyses in six peer-reviewed papers between 2007 and 2014. My key findings were as follows: over the last decade an increasing proportion of black African heterosexuals born abroad but diagnosed with HIV in the UK acquired HIV whilst living in the UK; outward migration from the UK may explain why some black African heterosexuals were lost to follow-up from HIV care; the proportion of black African heterosexuals diagnosed late with HIV has not changed substantially; the uptake of HIV testing among black African heterosexuals has increased over time but remains low compared with that among MSM. To minimize the risk of HIV transmission and to maximise the benefits of earlier detection my key recommendation is to promote regular HIV testing among black African women and men in a range of healthcare and community settings in E,W&NI, particularly in primary care.
  • References (16)
    16 references, page 1 of 2

    7.8.1 Review and roll-out the new method of assigning likely country of HIV infection......................................................................................................................138 7.8.5 Reduce the incidence of tuberculosis among HIV-diagnosed heterosexuals ..............................................................................................................140 7.6.1 Accurately measuring the impact of migration on heterosexual HIV transmission ...............................................................................................................133 292. Heijman RL, Stolte IG, Thiesbrummel HF, van Leent E, Coutinho RA, Fennema JS, et al. Opting out increases HIV testing in a large sexually transmitted infections outpatient clinic. Sex Transm Infect. 2009;85(4):249-55.

    293. Stolte IG, Gras M, Van Benthem BH, Coutinho RA, van den Hoek JA. HIV testing behaviour among heterosexual migrants in Amsterdam. AIDS Care. 2003;15(4):563-74.

    294. Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55(Rr-14):1-17; quiz CE1- 4.

    295. Hsieh Y, Beck K, Kelen G, Shahan J, Kraus C, Laeyendecker O, et al. High prevalence of undiagnosed HIV infection in patients who were not offered screening and patients who declined screening: Evaluation of a rapid hiv screening programme in a U.S. Urban Emergency Department. . STI and AIDS World Congress 2013; Vienna: BMJ Publishing Group; 2013.

    296. Health Protection Agency. Time to test for HIV: Expanding HIV testing in healthcare and community services in England London: Health Protection Agency; 2012 [cited 2015 17/03/2015]. Available from:

    297. Hartney T, Kennedy I, Crook P, Nardone A. Expanded HIV testing in highprevalence areas in England: results of a 2012 audit of sexual health commissioners. HIV Med. 2014;15(4):251-4.

    298. NHS Choices. Home HIV testing kits now legal in UK 2014 [cited 2015 14/04/2015]. Available from: http://www.nhs.uk/news/2014/04April/Pages/Home-HIVtesting-kits-now-legal-in-UK.aspx.

    299. Krause J, Subklew-Sehume F, Kenyon C, Colebunders R. Acceptability of HIV self-testing: a systematic literature review. BMC Public Health. 2013;13:735.

    300. Lyons MS, Lindsell CJ, Ruffner AH, Trott AT, Fichtenbaum CJ. Relationship of self-reported prior testing history to undiagnosed HIV positivity and HIV risk. Curr HIV Res. 2009;7(6):580-8.

    Reference lists of key review articles. 10. MEDLINE; hiv.ti [Limit to: Publication Year 2000-2011 and Humans and English Language]; 63952 results.

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